American Journal of Community Psychology

, Volume 42, Issue 1–2, pp 110–121 | Cite as

Mutual Help Groups for Mental Health Problems: A Review of Effectiveness Studies

  • Nancy Pistrang
  • Chris Barker
  • Keith Humphreys
Original Paper


This paper reviews empirical studies on whether participating in mutual help groups for people with mental health problems leads to improved psychological and social functioning. To be included, studies had to satisfy four sets of criteria, covering: (1) characteristics of the group, (2) target problems, (3) outcome measures, and (4) research design. The 12 studies meeting these criteria provide limited but promising evidence that mutual help groups benefit people with three types of problems: chronic mental illness, depression/anxiety, and bereavement. Seven studies reported positive changes for those attending support groups. The strongest findings come from two randomized trials showing that the outcomes of mutual help groups were equivalent to those of substantially more costly professional interventions. Five of the 12 studies found no differences in mental health outcomes between mutual help group members and non-members; no studies showed evidence of negative effects. There was no indication that mutual help groups were differentially effective for certain types of problems. The studies varied in terms of design quality and reporting of results. More high-quality outcome research is needed to evaluate the effectiveness of mutual help groups across the spectrum of mental health problems.


Mutual support group Self-help group Peer support Mental illness Outcome evaluation 



Keith Humphreys was supported by a Research Career Scientist award from the US Department of Veterans’ Affairs. Thanks to Kate Harvey for assisting with the literature searches and to Charlie Davidson for painstakingly refining their Boolean logic. John Cape gave encouragement and support and Steve Pilling provided valuable criticism. An earlier version of this paper was presented at the British Psychological Society 2004 Annual Conference.


  1. Barker, C., & Pistrang, N. (2005). Quality criteria under methodological pluralism: Implications for doing and evaluating research. American Journal of Community Psychology, 35, 201–212.PubMedCrossRefGoogle Scholar
  2. Borkman, T. J. (1990). Experiential, professional, and lay frames of reference. In T. J. Powell (Ed.), Working with self-help (pp. 3–30). Silver Spring, Maryland: NASW Press.Google Scholar
  3. Borkman, T. J. (1999). Understanding self-help/mutual aid: Experiential learning in the commons. New Brunswick, NJ: Rutgers University Press.Google Scholar
  4. Bright, J. I., Baker, K. D., & Neimeyer, R. A. (1999). Professional and paraprofessional group treatments for depression: A comparison of cognitive-behavioral and mutual support interventions. Journal of Consulting and Clinical Psychology, 67, 491–501.PubMedCrossRefGoogle Scholar
  5. Burti, L., Amaddeo, F., Ambrosi, M., Bonetto, C., Cristofalo, D., Ruggeri, M., et al. (2005). Does additional care provided by a consumer self-help group improve psychiatric outcome? A study in an Italian community-based psychiatric service. Community Mental Health Journal, 41, 705–720.PubMedCrossRefGoogle Scholar
  6. Caserta, M. S., & Lund, D. A. (1993). Intrapersonal resources and the effectiveness of self-help groups for bereaved older adults. The Gerontologist, 33, 619–629.PubMedGoogle Scholar
  7. Cheung, S.-K., & Sun, S. Y. K. (2000). Effects of self-efficacy and social support on the mental health conditions of mutual-aid organization members. Social Behavior and Personality, 28, 413–422.CrossRefGoogle Scholar
  8. Chinman, M., Kloos, B., O’Connell, M., & Davidson, L. (2002). Service providers’ views of psychiatric mutual support groups. Journal of Community Psychology, 30, 349–366.CrossRefGoogle Scholar
  9. Davidson, L. (2003). Living outside mental illness: Qualitative studies of recovery in schizophrenia. New York: New York University Press.Google Scholar
  10. Davidson, L., Chinman, M., Kloos, B., Weingarten, R., Stayner, D., & Tebes, J. K. (1999). Peer support among individuals with severe mental illness: A review of the evidence. Clinical Psychology: Science and Practice, 6, 165–187.CrossRefGoogle Scholar
  11. Davison, K. P., Pennebaker, J. W., & Dickerson, S. S. (2000). Who talks? The social psychology of illness support groups. American Psychologist, 55, 205–217.PubMedCrossRefGoogle Scholar
  12. den Boer, P. C. A. M., Wiersma, D., & van den Bosch, R. J. (2004). Why is self-help neglected in the treatment of emotional disorders? A meta-analysis. Psychological Medicine, 34, 971.CrossRefGoogle Scholar
  13. Dunham, P. J., Hurshman, A., Litwin, E., Gusella, J., Ellsworth, C., & Dodd, P. W. D. (1998). Computer-mediated social support: single young mothers as a model system. American Journal of Community Psychology, 26, 281–306.PubMedCrossRefGoogle Scholar
  14. Eysenbach, G., Powell, J., Englesakis, M., Rizo, C., & Stern, A. (2004). Health related virtual communities and electronic support groups: systematic review of the effects of online peer to peer interaction. British Medical Journal, 328, 1166–1170.PubMedCrossRefGoogle Scholar
  15. Galanter, M. (1988). Zealous self-help groups as adjuncts to psychiatric treatment: A study of Recovery, Inc. American Journal of Psychiatry, 145, 1248–1253.PubMedGoogle Scholar
  16. Gottlieb, B. H., & Peters, L. A. (1991). A national demographic portrait of mutual aid participants in Canada. American Journal of Community Psychology, 19, 651–666.CrossRefGoogle Scholar
  17. Helgeson, V. S., & Gottlieb, B. H. (2000). Support groups. In S. Cohen, L. G. Underwood, & B. H. Gottlieb (Eds.), Social support measurement, and intervention: A guide for health and social scientists (pp. 221–245). New York: Oxford University Press.Google Scholar
  18. Hogan, B. E., Linden, B. E., & Najarian, B. (2002). Social support interventions: do they work? Clinical Psychology Review, 22, 381–440.CrossRefGoogle Scholar
  19. Houston, T. K., Cooper, L. A., & Ford, D. E. (2002). Internet support groups for depression: A 1-year prospective cohort study. American Journal of Psychiatry, 159, 2062–2068.PubMedCrossRefGoogle Scholar
  20. Humphreys, K. (2000). Community narratives and personal stories in Alcoholics Anonymous. Journal of Community Psychology, 28, 495–506.CrossRefGoogle Scholar
  21. Humphreys, K. (2004). Circles of recovery: Self-help organizations for addictions. Cambridge: Cambridge University Press.Google Scholar
  22. Humphreys, K., & Rappaport, J. (1994). Researching self-help/mutual aid groups and organizations: Many roads, one journey. Applied and Preventive Psychology, 3, 217–231.CrossRefGoogle Scholar
  23. Humphreys, K., Phibbs, C. S., & Moos, R. H. (1996). Addressing self-selection effects in evaluations of mutual help groups and professional mental health services: An introduction to two-stage sample selection models. Evaluation and Program Planning, 19, 301–308.CrossRefGoogle Scholar
  24. Kessler, R. C., Mickelson, K. D., & Zhao, S. (1997). Patterns and correlates of self-help group membership in the United States. Social Policy, 27, 27–46.Google Scholar
  25. Klaw, E., Horst, D., & Humphreys, K. (2006). Inquirers, triers, and buyers of an alcohol harm reduction self-help organization. Addiction Research and Theory, 14, 527–535.CrossRefGoogle Scholar
  26. Kyrouz, E. M., Humphreys, K., & Loomis, C. (2002). A review of research on the effectiveness of self-help mutual aid groups. In B. J. White & E. J. Madara (Eds.), American self-help clearinghouse self-help group sourcebook (7 ed., pp. 71–85). Cedar Knolls, NJ: American Self-Help Group Clearinghouse.Google Scholar
  27. Levy, L. H. (2000). Self-help groups. In J. Rappaport & E. Seidman (Eds.), Handbook of community psychology (pp. 591–613). New York: Kluwer Academic.Google Scholar
  28. Lewis, G., Anderson, L., Araya, R., Elgie, R., Harrison, G., Proudfoot, J., et al. (2003). Self-help interventions for mental health problems. London: report to the Department of Health R&D programme.Google Scholar
  29. Lieberman, M. A., & Videka-Sherman, L. (1986). The impact of self-help groups on the mental health of widows and widowers. American Journal of Orthopsychiatry, 56, 435–449.PubMedGoogle Scholar
  30. Magura, S., Laudet, A. B., Mahmood, D., Rosenblum, A., & Knight, E. (2002). Adherence to medication regimens and participation in dual-focus self-help groups. Psychiatric Services, 53, 310–316.PubMedCrossRefGoogle Scholar
  31. Marmar, C. R., Horowitz, M. J., Weiss, D. S., Wilner, N. R., & Kaltreider, N. B. (1988). A controlled trial of brief psychotherapy and mutual-help group treatment of conjugal bereavement. American Journal of Psychiatry, 145, 203–209.PubMedGoogle Scholar
  32. Moher, D., Schulz, K. F., & Altman, D. G. (2001). The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomised trials. Journal of the American Medical Association, 285, 1987–1991.PubMedCrossRefGoogle Scholar
  33. Munn-Giddings, C., & Borkman, T. (2005). Self help/mutual aid as a psychosocial phenomenon. In S. Ramon & J. E. Williams (Eds.), Mental health at the crossroads. The promise of the psychosocial approach. Aldershot: Ashgate Publishing.Google Scholar
  34. Powell, T. J., Hill, E. M., Warner, L., Yeaton, W. H., & Silk, K. R. (2000). Encouraging people with mood disorders to attend a self-help group. Journal of Applied Social Psychology, 30, 2270–2288.CrossRefGoogle Scholar
  35. Powell, T. J., Yeaton, W. H., Hill, E. M., & Silk, K. R. (2001). Predictors of psychosocial outcomes for patients with mood disorders: the effects of self-help group participation. Psychiatric Rehabilitation Journal, 25, 3–11.PubMedGoogle Scholar
  36. Rappaport, J. (1993). Narrative studies, personal stories, and identity transformation in the mutual help context. Journal of Applied Behavioral Science, 29, 239–256.CrossRefGoogle Scholar
  37. Rathner, G., Bönsch, C., Maurer, G., Walter, M. H., & Söllner, W. (1993). The impact of a “guided self-help group” on bulimic women: a prospective 15 month study of attenders and non-attenders. Journal of Psychosomatic Research, 37, 389–396.PubMedCrossRefGoogle Scholar
  38. Roberts, L. J., Salem, D. A., Rappaport, J., Toro, P. A., Luke, D. A., & Seidman, E. (1999). Giving and receiving help: interpersonal transactions in mutual-help meetings and psychosocial adjustment of members. American Journal of Community Psychology, 27, 841–868.PubMedCrossRefGoogle Scholar
  39. Segal, S. P., & Silverman, C. (2002). Determinants of client outcomes in self-help agencies. Psychiatric Services, 53, 304–309.PubMedCrossRefGoogle Scholar
  40. Solomon, M., Pistrang, N., & Barker, C. (2001). The benefits of mutual support groups for parents of children with disabilities. American Journal of Community Psychology, 29, 113–132.PubMedCrossRefGoogle Scholar
  41. Trojan, A. (1989). Benefits of self-help groups: a survey of 232 members from 65 disease related groups. Social Science and Medicine, 29, 225–232.PubMedCrossRefGoogle Scholar
  42. Tudiver, F., Hilditch, J., Permaul, J. A., & McKendree, D. J. (1992). Does mutual help facilitate newly bereaved widowers? Report of a randomized controlled trial. Evaluation and the Health Professions, 15, 147–162.CrossRefGoogle Scholar
  43. Vachon, M. L. S., Lyall, W. A. L., Rogers, J., Freeman-Letofsky, K., & Freeman, S. J. J. (1980). A controlled study of self-help intervention for widows. American Journal of Psychiatry, 137, 1380–1384.PubMedGoogle Scholar
  44. Videka-Sherman, L., & Lieberman, M. A. (1985). The effects of self-help and psychotherapy intervention on child loss. American Journal of Orthopsychiatry, 55, 70–82.PubMedGoogle Scholar
  45. Ybarra, M. L., & Eaton, W. W. (2005). Internet-based mental health interventions. Mental Health Services Research, 7, 75–87.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Department of Clinical, Educational and Health PsychologyUniversity College LondonLondonUK
  2. 2.Veterans Affairs and Stanford University Medical CentersStanfordUSA

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